Document Detail

A prediction rule for food challenge outcome in children.
MedLine Citation:
PMID:  22360724     Owner:  NLM     Status:  Publisher    
To cite this article: Zomer-Kooijker K, Slieker MG, Kentie PA, van der Ent CK, Meijer Y. A prediction rule for food challenge outcome in children. Pediatric Allergy Immunology 2012: 00. ABSTRACT: Background:  In children with food-related symptoms, a food challenge is considered as the gold standard to diagnose allergy. If food allergy could be predicted by patient history and/or diagnostic tests, the number of time-consuming and sometimes risky food challenges could be decreased. We aimed to determine questionnaire and test-based characteristics, to predict the food challenge outcome (FCO) in children referred to a tertiary centre for the evaluation of food-related symptoms. Methods:  Pre-challenge standardized questionnaires, skin prick tests (SPT), and specific IgE levels (sIgE) were obtained in patients that underwent a food challenge in our hospital in 2009. Characteristics of patients with positive and negative FCO were compared, and uni- and multivariate associations between predictors and FCO were calculated. Based on the multivariate model, a risk score was developed to predict the FCO. Results:  One hundred and twenty-nine challenges were analyzed, 41.9% had a positive outcome. Median age of both groups was 4.9 yrs (range 2.8-8.3). Patients with a positive FCO reacted faster with symptoms after allergen ingestion and had higher sIgE levels compared to children with negative FCO. A clinical risk score was developed based on the index food, 'time between allergen ingestion and complaints' and sIgE levels (range 0-10). The prognostic capacity of this model (AUC) was excellent (0.90). The very high- and low-risk groups (24% of patients) are both predicted excellent without misclassification. Conclusion:  Positive FCO can be predicted by the index food, time between allergen ingestion and development of symptoms, and the sIgE level.
Kim Zomer-Kooijker; Martijn G Slieker; Petra A Kentie; Cornelis K van der Ent; Yolanda Meijer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-23
Journal Detail:
Title:  Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology     Volume:  -     ISSN:  1399-3038     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106718     Medline TA:  Pediatr Allergy Immunol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Department of Paediatric Pulmonology and Allergology Department of Paediatrics, University Medical Centre, Utrecht, Utrecht, The Netherlands.
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